Anatomic-functional profiles in duodenal ulcer

Gastric acid secretion, gastrinemia, the type of gastritis of the fundic mucosa and the parietal cell mass, expressed by means of a 'parietal index', were considered in 70 patients with active duodenal ulcer. Hypersecretion was found in 60% of cases, normosecretion in 35.7% and hyposecretion in 4.3%, while achlorhydria was absent. Chronic fundic gastritis of the superficial or follicular type occurred at a similar rate in normosecretors (22%) and in hypersecretors (26%), being constantly of the preatrophic type in the 3 cases of hyposecretion. The parietal index was strictly correlated with maximal acid output but there was no correlation between gastrinemia and the secretory state or with the histological picture of the fundic mucosa. The results outline the prevalence of hypersecretion-hyperparietalism in duodenal ulcer but indicate also the frequent occurrence of normosecretion and normoparietalism and the rare finding of hypersecretion and hypoparietalism.